A few things can block your way to having cosmetic plastic surgery. Because many states require a physical before any rejuvenation surgery, an unknown or returning ailment may turn up, blocking surgery until you get a medical O.K.

The price may be too steep. Or, perhaps the surgeon sees somebody else besides the patient wanting plastic surgery to go forward – like many overbearing parents who want nose jobs for their teen as a status symbol.

               (Read more about teen nose jobs.)

It may be clear to the surgeon that no amount of  plastic surgery can make some patients happy and that a case of a psychological condition known as body dysmorphic order probably exists.

               (Read more about body dysmorphic order.)

But many plastic surgery practices place an absolute roadblock on any cosmetic surgery if you smoke.

It’s not a moralistic thing. Actually, the cause is medical and has to do with tobacco use carrying a significant risk of surgical complications, both under anesthesia and in surgery.

However, most cosmetic plastic surgeons will give smokers a pass if they stop smoking and return in two weeks.

Here’s what cosmetic surgeons and others are concerned about in smokers:

Anesthesiologists want patients to be unaware and completely still during the procedure. But cigarette smoke creates a continuing condition of irritation and inflammation in the bronchial tubes that lead to the lungs.

To avoid coughing, wheezing or coping with extremely thick mucus, the anesthesiologist must give yet more anesthesia, making it harder for the patient to easily awaken without sickness and leave the surgical facility on a timely basis.

In rhinoplasty, the inside of a smoker’s nose becomes as irritated as the lining of the lungs. Smoking is hard on the nose lining because the normal nasal mucus is dried out. Thus, thick, rubbery mucous gathers at the back of the throat, triggering the cough reflex. And that’s not something you want to encourage while having or recovering from any surgery. Bleeding may be a problem during and after the smoker’s plastic surgery, too.

It’s even worse for a facelift. In that procedure, facial and neck skin must be lifted from its bed and moved. Elements in smoke – carbon monoxide, carbon dioxide and nicotine — retard oxygen saturated blood to those tissues and may even threaten skin survival. That, in turn, may cause the breakdown of the surgical wound, infection and scarring. That would create some face lift, huh?

(Look at some face & neck lift before & after pictures – done on non-smoking patients, of course.)